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NBME 22 Answers

nbme22/Block 1/Question#35 (reveal difficulty score)
A 35-year-old man is brought to the hospital ...
Alteration of the thermostatic set point ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +20  upvote downvote
submitted by โˆ—keycompany(351)
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oAaerlntti fo het hcstatiteorm ets itnop is a ytmaclhpohai sesrcop aetedmid yb alndrgosipatsn nad is edidnntepne of hte acmtepshyti oseurnv mysset.

,B ,C D, adn E all iqueerr tasmihcpeyt enrsve to eiltlci a sernpso.e

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pg32  nCa yeanno xnpilea het msihecman hidbne igishnvre dna hte hectiaymtsp usnvoer ystm?se +4
mdmikek89  taapoyHluhsm reylas htghuro eth comnoaiut esnrouv smeys.t You utc eht a,leyr ouy nca oynl chngae hte ichttaermsot tse int,po tub het yodb a'tnc .react +1
umpalumpa  Gs,yu I htkin ttah fro het einivgshr vireelntaat the oipnt is NOT thta hsctiatpmye svrene ltoconr evrihgins lyaacu,t(l I htv'ean udfon rctsalei on ebpmud thta yssa htta sveihrgni si todlorncle by .capsytim)hte HTe saestei way ot ihtkn is htat sith tp ash a cmsystie cnnitiefo ka(a tSRmIc-Ssseiy yfaiotlnarmm eosrsnep mrey)o.nds nI IRSS, pt cna ahve ;3&t5Tl C ro &tg;83 C, TUB ti si oerm cmnomo ot vhae fevre ntah yphoaihtrem. irinesgndoC st,ih you anc yiasle oeruut-l hte revshniig nar.eetviatl +1

Even brown fat needs SNS == release of NE == binds to beta 3 receptor on fat == uncoupling of ox phos!

+6/- apurva(101)


 +4  upvote downvote
submitted by โˆ—qfever(67)
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amaohsytuplH lignrooctln tpraeeuetrm ste poitn si lefbriy dineonmet ni aomtPha 8120 iendiot agpe 1,3 hCerpat 2 III anCiarld sings fo ntnilfmomaia D. Ferve

ygsPeneo &g-t; gaaocmherp reslaee -I1L dna FTN g-;t& eanirsced oscecygxlenyoa itcytiva ni auymotsahlph scpaeruvlair esllc -tg&; canideres shhamplytoau GPE2 gt&-; esdrai pmruttaeere ets point

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 +0  upvote downvote
submitted by gribear(0)
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Cna osonmee pneaxil yhw ehwn uoy ernsctta eht saipln codr siuepror ot teh lelve fo ehtispmtcya wfuootl -- nad you tge a tysimsce ifnonteic -- eth eersosnp is eoanattril of hte smehitotract tse p?tnio

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its_raining_jimbos  So I ocshe ahtt noe saecueb ets pitno si dclretnolo yb hte tsuhahlmyoap 2EP(G nda L-1I dmeetai eervf in eht msauployath)h nad het etsr fo the eswanr hociecs nvdloeiv iomtegsnh blwoe eth ellev tath hsa been eatntrc.des toN 001% esur fi ahttsโ€™ cauaerct oh.uhtg +5
noselex  gderAe hwti _imjnsn_ig@iobatsir -- erFve is edmeaitd yb neagirtl ste itpon ni .lmhhpoayaust llA eth rtoeh soc,hcie as rfa sa I nca etl,l nveoilv mhicytteasp vnesre dna rethi eftcsef at rtagte .orgnsa +2

You might not be able to change the temperature because you have no sympathetic outflow, but the actual "resetting" of the thermostatic set point is mediated via the hypothalamus and prostaglandins

+2/- spow(50)


 -1  upvote downvote
submitted by โˆ—j000(17)
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i got thsi eqsnituo gnrwo, tub i ktihn thaw thsi sutqieno si ylealr askgin si ahwt nsphape in a ytsimsec nfoi:itecn hwich is erevf

in yiecsmst fnen,tocii eht most oubsoiv nsig ot look fro si a vef,re ont ieyelanrcss inrev,hisg tenags,iw htae oircntpoud by bowrn ,fat t.ce

nda who deos erfve ocu?rc ekil oeesonm eaalyrd otn:iedmen esnpgoye -g&-t; shcaormgepa lnaeriges 1LI nad NFT ihchw ecsrnsaei COX vaitciyt in yoapstmuhhal aslrrvpuaeic clels, inreeacs pndtroociu of EGP2 ni sympoautalhh nda ertes eth etpeuearmtr est .tpnio

i hktin hte ehowl aserph eolm"tecp snottcainer fo het aslpin cdor ruprosei to the velel fo hiptatcs".m..ey si a oindcs.ttria ti tjsu sltel you tath dtpeenelvmo of a freve sah tihngon ot od htiw it

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j000  meondteelpv of a reevf ni tsmsiyec fitinceon ash gonhtin ot od ithw eymshtaptci rvsunoe wflo, os even it's ,dnrujie vreef lduow lsitl .uorcc I nitkh isth tqunsoei si ujst ngaksi owh deso evefr cocur ni otno/lmeafmfnntniciaii ntsitiuoa. +1
b1ackcoffee  ,So ohw od yuo nxlpeai eth alcaut erefv yb jtsu cagningh teh soae?rt?thtm eeFrv ffc'eet' IS nedur cyihteamptS rno,tlco sjut teh aniggcnh het ertteeauprm e(ikl hrt)oatestm is eedtamid by enocksyti and aytlomsuaph.h +2
j000  oh i see twha you ane,m lwel i 'ntidd nwok htta, so hasntk ofr anlciigrfy ahtt. ehwr,eov sebad on yruo oaixa,neptnl it udowl llits get su ot eth hirgt sranew chwhi is oantiter"la fo tohstraemcti est tnpoi", ton eht refev ffeect efl.ist +1

So, how do you explain the actual fever by just changing the thermostat?? Fever 'effect' IS under Sympathetic control, just the changing the temperature (like thermostat) is mediated by cytokines and hypothalamus

+1/- b1ackcoffee(115)


 -1  upvote downvote
submitted by โˆ—mdmikek89(6)
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Okya yosb nad slgri tish uoietsqn is eesair nath yuo nkh.ti

ltumoapHyhsa yresla via eth hptcmeityas vresonu sesytm to cnrloot eht dboy nhew a nwe ste tpnio sa neeb ceherda in setl sf.e.ea.c.eyv.sur.a f.yntb.eii...onc

If the nnocoictne ewbnete eht msuyaohhltap nad snpila odrc (inlaym hte pseymcaitht toluo)fw is ,utc het sautlham octnna arely eth obyd tieaconr fo a reefv, utb teh hoyshlatumap sfelit acn tlsli ghcaen hte ste .itpno

omoB

tinhiW het aibr,n the utioanocm euvrson tsmyes is ledreuatg yb hte ypaslh.outahm oAcntumio usifntnoc liudnec otrocnl of rsnoptiaie,r iaacrdc rngileaotu h(et acrcadi lcnotro crente,) omtsovaor tcaiiytv (eth tooosrvma cre),nte dna inaretc xefler otsanic ucsh sa hgcig,uno nnseegiz, ogwwasnill nda gmiviont.

-BE ucorc as a srtlue fo a naghce ni est tp.ion

A eppshna to eucsa eth -EB nehw a nwe est onitp si ced.earh

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 -1  upvote downvote
submitted by โˆ—isaacyo94(13)
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In mscseyti niofet,cin wt'ounld you teg tceuaonsu sDLITOaNoAvI i.(.e udrbeivstiti )shoc?k hiTs swa my resoiangn rof ohcingos )B ni isth cakwy qt.sounie

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neilfespiritu  emaS +1



 -3  upvote downvote
submitted by โˆ—gh889(154)
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Fomr eHrnaodoenSyohkku no ridtde:

Waht eht ieoutnsq si gttnieg at si teh pyhecsttima cnahi was r.spead tI asw a trelbeir ayw of nigodrw .it

Yrou rnorieta osaythhpluma is neloiperbss fro oolcnig rufetsae adn is uendr eacirpttphmaays rocl.nto A noesli oduwl aeucs iyepahhre.tmr

rYou oresrtopi atshlhypmuoa si seirnbspeol orf aiethng enhw reu'yo oldc adn ot etreegna the erveF seepnrso adn is nrdue eytiscpathm nolo.rct A neilos wodul aeusc prh.mhiateoy

nI tsih uonetiqs it si iypslm nsiagk a respon esgt kis,c oastmlyahhpu saw ,adreps hwat hsn.aepp

sn:werA hotyamalhpsu lliw sllti be blea ot aeleetv ets ydob arurmpeette to eatlbt .eioicnnft

tinH: FI heyt vige a qenitsuo iarsiml to sith ubt rewodedr to leidcnu a losnei fo eht ytitmcshpae bsifre ro of hte athmayp,slohu yuo lowud in ntru NTO eb lbae ot eeagntre a veefr soreepns to cnfniiot.e eTh tumhpyhosala dlwuo eb nlyrteei eudnr epmaspthtaciyar tnclroo

ihsT dads meor ntoectx ot hte afct hte Q estats htta hte thstyaipmsec saw repsad

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oslerweberrendu  So, thsi yass ptyimcsahet oasl adpesr dan tymlsopuaahh loas e.pasdr Tenh hawt aws owgnr with sith aiillcnc ae?cs? +1
adong  i tikhn teh ptyeaimcsht yssmet si utyclala ieiapmrd b/c its' uct eorfeb ti nca lt.f.."touw"oa tlaes sti' eth ylon yaw siht aeskm enses +4
suckitnbme  I a.eerg I ktinh eth snetoqiu smet is asyngi het hpsstiaytecm eerw ed.niselo Not tath htey rewe sderpa. +4



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